The UPTAKE study: implications for the future of COVID-19 vaccination trial recruitment in UK and beyond

Abstract Background Developing a safe and effective vaccine will be the principal way of controlling the COVID-19 pandemic. However, current COVID-19 vaccination trials are not adequately representing a diverse participant population in terms of age, ethnicity and comorbidities. Achieving the representative recruitment targets that are adequately powered to the study remains one of the greatest challenges in clinical trial management. To ensure accuracy and generalisability of the safety and efficacy conclusions generated by clinical trials, it is crucial to recruit patient cohorts as representative as possible of the future target population. Missing these targets can lead to reduced validity of the study results and can often slow down drug development leading to costly delays. Objective This study explores the key factors related to perceptions and participation in vaccination trials. Methods This study involved an anonymous cross-sectional online survey circulated across the UK. Statistical analysis was done in six phases. Multi-nominal logistic models examined demographic and geographic factors that may impact vaccine uptake. Results The survey had 4884 participants of which 9.44% were Black Asian Minority Ethnic (BAME). Overall, 2020 (41.4%) respondents were interested in participating in vaccine trials; 27.6% of the respondents were not interested and 31.1% were unsure. The most interested groups were male (OR = 1.29), graduates (OR = 1.28), the 40–49 and 50–59 age groups (OR = 1.88 and OR = 1.46 respectively) and those with no health issues (OR = 1.06). The least interested groups were BAME (OR = 0.43), those from villages and small towns (OR = 0.66 and 0.54 respectively) and those aged 70 and above (OR = 1.11). Conclusions In order to have a vaccination that is generalisable to the entire population, greater work needs to be done in engaging a diverse cohort of participants. Public health campaigns need to be targeted in improving trial recruitment rates for the elderly, BAME community and the less educated rural population.

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The UPTAKE healStudy: Implications for the Future of COVID-19 Vaccination Trial Recruitment in UK and Beyond

10.21203/rs.3.rs-136882/v1 ◽

2021 ◽

Author(s):

Sonika Sethi ◽

Aditi Kumar ◽

Anandadeep Mandal ◽

Mohammed Shaikh ◽

Claire Anne Hall ◽

...

Keyword(s):

Online Survey ◽

Logistic Models ◽

Small Towns ◽

Vaccine Uptake ◽

Effective Vaccine ◽

Trial Recruitment ◽

Trial Management ◽

Cross Sectional ◽

Study Results ◽

The Future

Abstract Background: Developing a safe and effective vaccine will be the principal way of controlling the COVID-19 pandemic. However, current COVID-19 vaccination trials are not adequately representing a diverse participant population in terms of age, ethnicity and comorbidities. Achieving the representative recruitment targets that are adequately powered to the study remains one of the greatest challenges in clinical trial management. To ensure accuracy and generalizability of the safety and efficacy conclusions generated by clinical trials, it is crucial to recruit patient cohorts as representative as possible of the future target population. Missing these targets can lead to reduced validity of the study results, and can often slow down drug development leading to costly delays. This study explores the key factors related to perceptions and participation in vaccination trials. Methods: This study involved an anonymous cross-sectional online survey circulated across the UK. Statistical analysis was done in six phases. Multi-nominal logistic models examined demographic and geographic factors that may impact vaccine uptake. Results: The survey had 4884 participants of which 9·44% were BAME (Black Asian Minority Ethnic). Overall 2020 (41.4%) respondents were interested in participating in vaccine trials; 27.6% of the respondents were not interested and 31.1.% were unsure. The most interested groups were male (OR=1.290), graduates (OR=1.277), the 40-49 and 50-59 age group (OR=1.880 and OR=1.460 respectively) and those with no health issues (OR=1.064). The least interested groups were BAME (OR=0.427), those from villages and small towns (OR=0.66 and 0.54 respectively), and those aged 70 and above (OR=1.11).Conclusions: In order to have a vaccination that is generalizable to the entire population, greater work needs to be done in engaging a diverse cohort of participants. Public health campaigns need to be targeted in improving trial recruitment rates for the elderly, BAME community and the less educated rural population.

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Willingness to Receive the COVID-19 and Seasonal Influenza Vaccines among the Saudi Population and Vaccine Uptake During the Initial Stage of the National Vaccination Campaign: A Cross-Sectional Survey

Vaccines ◽

10.3390/vaccines9070765 ◽

2021 ◽

Vol 9 (7) ◽

pp. 765

Author(s):

Amel Ahmed Fayed ◽

Abeer Salem Al Shahrani ◽

Leenah Tawfiq Almanea ◽

Nardeen Ibrahim Alsweed ◽

Layla Mohammed Almarzoug ◽

...

Keyword(s):

Saudi Arabia ◽

Perceived Risk ◽

Online Survey ◽

Seasonal Influenza ◽

Vaccination Campaign ◽

Vaccine Uptake ◽

Influenza Vaccines ◽

Vaccine Hesitancy ◽

Cross Sectional ◽

To Receive

This study aimed to assess the willingness to receive the coronavirus disease 2019 (COVID-19) and seasonal influenza vaccines and vaccine uptake during the early stage of the national vaccination campaign in Saudi Arabia. A cross-sectional online survey was conducted among adult Saudis between 20 January and 20 March 2021. The questionnaire addressed vaccine hesitancy, perceived risk, willingness, and vaccine uptake. Approximately 39% of the participants expressed vaccine hesitancy, and 29.8% and 24% felt highly vulnerable to contracting COVID-19 and seasonal influenza, respectively. The majority (59.5%) were willing to receive the COVID-19 vaccine, although only 31.7% were willing to receive the flu vaccine. Adjusted analysis showed that vaccine hesitancy (OR 0.34, 95% CI 0.27–0.43) and the perception of being at high risk (OR 2.78, 95% CI 1.68–4.60) independently affected the intention to be vaccinated. Vaccine hesitancy was similar among those who were willing to be vaccinated (29.8%) and those who had already been vaccinated (33.1%). The perceived risk was significantly higher among those who had been vaccinated (48.1%) than among those who were willing to be vaccinated but had not yet been vaccinated (29.1%). In conclusion, the acceptance of the COVID-19 vaccine in Saudi Arabia is high. Saudis who received the vaccine had a similar level of vaccine hesitancy and a higher level of perceived risk.

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COVID-19 Vaccine Acceptance in Azuay Province, Ecuador: A Cross-Sectional Online Survey

Vaccines ◽

10.3390/vaccines9060678 ◽

2021 ◽

Vol 9 (6) ◽

pp. 678

Author(s):

Julio Jaramillo-Monge ◽

Michael Obimpeh ◽

Bernardo Vega ◽

David Acurio ◽

Annelies Boven ◽

...

Keyword(s):

Rural Areas ◽

Online Survey ◽

Vaccination Campaign ◽

Postgraduate Education ◽

Effective Vaccine ◽

Cross Sectional ◽

Lower Education Level ◽

Vaccination Acceptance ◽

History Of ◽

High Level

We investigated the COVID-19 vaccination acceptance level in Azuay province, Ecuador through an online survey from 12th to 26th February (before the start of the COVID-19 vaccination campaign in Ecuador). Overall, 1219 respondents participated in the survey. The mean age was 32 ± 13 years; 693 participants (57%) were female. In total, 1109 (91%) of the participants indicated they were willing to be vaccinated with a COVID-19 vaccine, if the vaccine is at least 95% effective; 835 (68.5%) if it is 90% effective and 493 (40.5%) if it is 70% effective; 676 (55.5%) participants indicated they feared side effects and 237 (19.4%) thought the vaccine was not effective. Older age, having had a postgraduate education, a history of a negative COVID-19 test, a high level of worry of contracting COVID-19, believing that COVID-19 infection can be prevented with a vaccine and understanding there is currently an effective vaccine against COVID-19 were associated with higher vaccination acceptance. A vaccination education campaign will be needed to increase the knowledge of Ecuadorians about the COVID-19 vaccine and to increase their trust in the vaccine. People with a lower education level and living in rural areas may need to be targeted during such a campaign.

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Loneliness and Its Association With Social Media Use During the COVID-19 Outbreak

Social Media + Society ◽

10.1177/20563051211033821 ◽

2021 ◽

Vol 7 (3) ◽

pp. 205630512110338

Author(s):

Tore Bonsaksen ◽

Mary Ruffolo ◽

Janni Leung ◽

Daicia Price ◽

Hilde Thygesen ◽

...

Keyword(s):

Social Media ◽

Online Survey ◽

Media Use ◽

Age Groups ◽

The United States ◽

Social Media Use ◽

Cross Sectional ◽

Social And Emotional ◽

Emotional Loneliness ◽

Social Loneliness

Social distancing rules during the COVID-19 pandemic changed social interaction for many and increased the risk of loneliness in the general population. Social media use has been ambiguously related to loneliness, and associations may differ by age. The study aimed to examine loneliness and its association with social media use within different age groups during the COVID-19 pandemic. A cross-sectional online survey was conducted in Norway, the United Kingdom, the United States, and Australia during April/May 2020, and 3,810 participants aged 18 years or above were recruited. Multiple regression analyses were conducted to examine associations between social media use and social and emotional loneliness within separate age groups. Emotional loneliness was higher among young adults and among those who used social media several times daily. Adjusting by sociodemographic variables, using more types of social media was associated with lower social loneliness among the oldest participants, and with higher emotional loneliness among the youngest participants. Among middle-aged participants, using social media more frequently was associated with lower social loneliness. We found that the associations between social media use and loneliness varied by age. Older people’s engagement on social media may be a resource to reduce loneliness during the COVID-19 pandemic. We observed higher levels of loneliness among high-frequent social media users of younger age.

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Intention to Be Vaccinated for COVID-19 among Italian Nurses during the Pandemic

Vaccines ◽

10.3390/vaccines9050500 ◽

2021 ◽

Vol 9 (5) ◽

pp. 500

Author(s):

Marco Trabucco Aurilio ◽

Francesco Saverio Mennini ◽

Simone Gazzillo ◽

Laura Massini ◽

Matteo Bolcato ◽

...

Keyword(s):

Vaccine Efficacy ◽

Online Survey ◽

Vaccine Development ◽

Vaccine Coverage ◽

World Health ◽

Vaccine Hesitancy ◽

Effective Vaccine ◽

Online Questionnaire ◽

Cross Sectional ◽

Female Sex

Background: While the COVID-19 pandemic has spread globally, health systems are overwhelmed by both direct and indirect mortality from other treatable conditions. COVID-19 vaccination was crucial to preventing and eliminating the disease, so vaccine development for COVID-19 was fast-tracked worldwide. Despite the fact that vaccination is commonly recognized as the most effective approach, according to the World Health Organization (WHO), vaccine hesitancy is a global health issue. Methods: We conducted a cross-sectional online survey of nurses in four different regions in Italy between 20 and 28 December 2020 to obtain data on the acceptance of the upcoming COVID-19 vaccination in order to plan specific interventions to increase the rate of vaccine coverage. Results: A total of 531 out of the 5000 nurses invited completed the online questionnaire. Most of the nurses enrolled in the study (73.4%) were female. Among the nurses, 91.5% intended to accept vaccination, whereas 2.3% were opposed and 6.2% were undecided. Female sex and confidence in vaccine efficacy represent the main predictors of vaccine intention among the study population using a logistic regression model, while other factors including vaccine safety concerns (side effects) were non-significant. Conclusions: Despite the availability of a safe and effective vaccine, intention to be vaccinated was suboptimal among nurses in our sample. We also found a significant number of people undecided as to whether to accept the vaccine. Contrary to expectations, concerns about the safety of the vaccine were not found to affect the acceptance rate; nurses’ perception of vaccine efficacy and female sex were the main influencing factors on attitudes toward vaccination in our sample. Since the success of the COVID-19 immunization plan depends on the uptake rate, these findings are of great interest for public health policies. Interventions aimed at increasing employee awareness of vaccination efficacy should be promoted among nurses in order to increase the number of vaccinated people.

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Adenovirus and RNA-based COVID-19 vaccines’ perceptions and acceptance among healthcare workers in Saudi Arabia: a national survey

BMJ Open ◽

10.1136/bmjopen-2020-048586 ◽

2021 ◽

Vol 11 (6) ◽

pp. e048586

Author(s):

Mohamad-Hani Temsah ◽

Mazin Barry ◽

Fadi Aljamaan ◽

Abdullah Alhuzaimi ◽

Ayman Al-Eyadhy ◽

...

Keyword(s):

Saudi Arabia ◽

Healthcare Workers ◽

Online Survey ◽

Healthcare Providers ◽

Vaccine Uptake ◽

Vaccine Hesitancy ◽

Cross Sectional ◽

Validated Questionnaire ◽

Vectored Vaccine ◽

To Receive

ObjectivesThe aim of this study was to compare the perception, confidence, hesitancy and acceptance rate of various COVID-19 vaccine types among healthcare workers (HCWs) in Saudi Arabia, a nation with Middle East respiratory syndrome coronavirus experience.DesignNational cross-sectional, pilot-validated questionnaire.SettingOnline, self-administered questionnaire among HCWs.ParticipantsA total of 2007 HCWs working in the Kingdom of Saudi Arabia participated; 1512 (75.3%) participants completed the survey and were included in the analysis.InterventionData were collected through an online survey sent to HCWs during 1–15 November 2020. The main outcome measure was HCW acceptance of COVID-19 candidate vaccines. The associated factors of vaccination acceptance were identified through a logistic regression analysis and via measurement of the level of anxiety, using the Generalised Anxiety Disorder 7 scale.ResultsAmong the 1512 HCWs who were included, 62.4% were women, 70.3% were between 21 and 40 years of age, and the majority (62.2%) were from tertiary hospitals. In addition, 59.5% reported knowing about at least one vaccine; 24.4% of the participants were sure about their willingness to receive the ChAdOx1 nCoV-19 vaccine, and 20.9% were willing to receive the RNA BNT162b2 vaccine. However, 18.3% reported that they would refuse to receive the Ad5-vectored vaccine, and 17.9% would refuse the Gam-COVID-Vac vaccine. Factors that influenced the differential readiness of HCWs included their perceptions of the vaccine’s efficiency in preventing the infection (33%), their personal preferences (29%) and the vaccine’s manufacturing country (28.6%).ConclusionsAwareness by HCWs of the several COVID-19 candidate vaccines could improve their perceptions and acceptance of vaccination. Reliable sources on vaccine efficiency could improve vaccine uptake, so healthcare authorities should use reliable information to decrease vaccine hesitancy among frontline healthcare providers.

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Fashion designers' attitude-behaviour inconsistencies towards a sustainable business model: a neutralisation theory perspective

Journal of Fashion Marketing and Management ◽

10.1108/jfmm-05-2021-0128 ◽

2021 ◽

Vol ahead-of-print (ahead-of-print) ◽

Author(s):

Asphat Muposhi ◽

Brighton Nyagadza ◽

Chengedzai Mafini

Keyword(s):

South Africa ◽

Online Survey ◽

Emerging Market ◽

Survey Study ◽

Future Research ◽

Cross Sectional ◽

Content Type ◽

Study Results ◽

Sustainable Fashion ◽

Fashion Designers

PurposeFashion designers in South Africa remain ambivalent in embracing sustainable fashion. This study examines the role of neutralisation techniques on attitude towards sustainable fashion. The study was conducted in South Africa, an emerging market known for water scarcity and pollution emanating from the textile industry.Design/methodology/approachA structured questionnaire was used to collect cross-sectional data from a sample of 590 fashion designers using a web-based online survey. Study constructs were drawn from the neutralisation theory and theory of planned behaviour.FindingsStandard multiple regression analysis results identified denial of injury, appeal to higher loyalties and external locus of control as the major rationalisation techniques influencing South African designers' negative attitudes towards sustainable fashion.Research limitations/implicationsResearch was conducted in South Africa where the concept of sustainable fashion is still at developmental stages. The generalisation of the study findings may be enhanced by extending the study to other markets with a fully developed market for sustainable fashion.Practical implicationsThe study results underscore the necessity of reducing social, structural and institutional barriers associated with the adoption of sustainable fashion. This study provides input towards efforts to develop attitude change strategies to stimulate designers to embrace sustainable fashion.Originality/valueThe research study contributes to theory, practice and future research.

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Video-Based Communication and its Association with Loneliness, Mental Health and Quality of Life among Older People during the COVID-19 Outbreak

10.20944/preprints202104.0520.v1 ◽

2021 ◽

Author(s):

Tore Bonsaksen ◽

Hilde Thygesen ◽

Janni Leung ◽

Mary C. Ruffolo ◽

Mariyana Schoultz ◽

...

Keyword(s):

Quality Of Life ◽

Mental Health ◽

Older People ◽

Online Survey ◽

Age Groups ◽

Psychological Outcomes ◽

Age Group ◽

Communication Tools ◽

Study Results

The aim of the study was to examine the use of video-based communication and its association with loneliness, mental health and quality of life in older adults (60-69 years versus 70+ years) during the COVID-19 pandemic. A cross-sectional online survey was conducted in Norway, UK, USA and Australia during April/May 2020, and 836 participants in the relevant age groups were included in the analysis. Multiple regression analyses were conducted to examine associations between use of video-based communication tools and loneliness, mental health and quality of life within age groups, while adjusting by sociodemographic variables. Video-based communication tools were found to be more often used among participants aged 60-69 years (60.1%), compared to participants aged 70 or above (51.8%, p < 0.05). Adjusting for all variables, use of video-based communication was associated with less loneliness (β = -0.12, p < 0.01) and higher quality of life (β = 0.14, p < 0.01) among participants aged 60-69 years, while no associations occurred for participants in the oldest age group. The use of video-based communication tools was therefore associated with favorable psychological outcomes among participants in their sixties, but not among participants in the oldest age group. The study results support the notion that age may influence the association between use of video-based communication tools and psychological outcomes amongst older people.

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ULTRASOUND;

The Professional Medical Journal ◽

10.29309/tpmj/2012.19.02.2005 ◽

2012 ◽

Vol 19 (02) ◽

pp. 187-192

Author(s):

EJAZ HUSSAIN SIDDIQUI ◽

SAAD SIDDIQUI ◽

NOREEN SHAH

Keyword(s):

Pediatric Population ◽

Adult Population ◽

Age Groups ◽

X Rays ◽

Geriatric Population ◽

Cross Sectional ◽

Study Results ◽

Significant Difference ◽

Ultrasound Findings ◽

Hepatobiliary Diseases

Objectives: To assess common presenting features and the role of Ultrasound in evaluation of Hepatobiliary diseases in ourpopulation. Design: Cross sectional study. Setting: Khyber X rays, Khyber Medical Centre, Peshawar. Period: August 2010 to December2010. Material and Methods: Data from patients presenting for evaluation of Hepatobiliary diseases was analyzed for presenting complaintsand ultrasound findings according to objectives of the study. Results: In total 197 cases were included in the study. The age wise categorizationincluded pediatric population (6.1%) adult population (87.3%) and geriatric population (6.6%). Upper abdominal pain was the most commonpresenting feature in all age groups as well as in both genders. Cholelithiasis with or without cholecystitis was the most common ultrasoundfinding in all age groups. No statistically significant difference was found between presenting features or ultrasound findings in different agegroups as well as across gender. Conclusions: Hepatobiliary diseases are among major illnesses in our region. Ultrasound is a sensitive anduseful tool for screening and evaluation of Hepatobiliary disorders.

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Assessing Patient Participation Burden Based on Protocol Design Characteristics

Therapeutic Innovation & Regulatory Science ◽

10.1177/2168479019867284 ◽

2019 ◽

pp. 216847901986728

Author(s):

Kenneth Getz ◽

Venkat Sethuraman ◽

Jessica Rine ◽

Yaritza Peña ◽

Sharma Ramanathan ◽

...

Keyword(s):

Online Survey ◽

Protocol Design ◽

Retention Rates ◽

Cross Sectional ◽

Perceived Burden ◽

Study Results ◽

Design Characteristics ◽

And Performance ◽

Viable Approach ◽

Patient Burden

Background: Although a number of studies have quantitatively measured investigative site burden to administer increasingly complex protocol designs, robust scholarly research has not been performed to quantify the burden that patients face as participants in clinical trials. Methods: This paper presents the results of a cross-sectional pilot study conducted by the Tufts Center for the Study of Drug Development and ZS Associates among nearly 600 patients via an online survey conducted between February and March 2019. Respondents rated the perceived burden of 60 commonly administered protocol procedures. The association and relationship between overall patient burden—derived from aggregating mean perceived burden ratings for individual procedures—and performance (eg, screen failure and retention rates, clinical trial cycle times) for a cross-sectional sample of 137 individual protocols was assessed. Descriptive statistics, significance tests, and univariate analyses were performed. Results: Strong positive, statistically significant associations were observed between a composite measure of patient burden and protocol-specific design and performance measures, most notably study visits above the tolerable mean and the study conduct duration from first patient first visit to last patient last visit. Conclusions: The study results suggest a new and viable approach to optimize protocol design and improve patient engagement.

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